Clinical Background
Use of tobacco products, particularly smoking, is a leading but preventable cause of disease, disability and death.
Adverse health effects include:
- Cancers - lung, larynx, oral cavity, nasal cavity, paranasal sinuses, esophagus, pancreas, liver, stomach, cervix and leukemia
- Cardiac and neurologic disease - a leading cause of coronary disease, stroke
- Pulmonary disease - chronic obstructive pulmonary disease (includes chronic bronchitis and emphysema), asthma, respiratory infections and an overall decrease in pulmonary function
- Pregnancy - difficulty in conceiving, intrauterine growth retardation and low birth weight
- Second-hand smoke (a confirmed human carcinogen) is implicated in pulmonary disease, lung cancer and coronary artery disease in non-smokers
Monitoring for tobacco use is helpful in the following situations:
- Compliance with requirements in smoking cessation programs
- Candidates for orthopedic surgery (particularly spinal fusion), pulmonary therapy and organ transplant programs
- Identification of tobacco-using patients on drug therapy for a variety of health problems
- Women on high-level estrogen therapy (increased risk for stroke and heart attack)
- Child custody cases when parent needs to comply with smoking cessation program as condition of visitation rights
- Experimental nicotine therapy in cognitive degeneration disorders, e.g., Alzheimer disease, Parkinson disease and attention deficit/hyperactivity disorder (ADHD)
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